Butzner Michael, Amonkar Sanika, Chen Meiling, Papademetriou Eros, Potluri Ravi, Liu Xing, Abraham Theodore
Health Economics and Outcomes Research, Cytokinetics Incorporated, South San Francisco, CA, United States.
School of Medicine, University of California, San Francisco, CA, United States.
Front Cardiovasc Med. 2025 Apr 7;12:1463439. doi: 10.3389/fcvm.2025.1463439. eCollection 2025.
Previous studies of patients with symptomatic obstructive hypertrophic cardiomyopathy (oHCM) have reported worse clinical burden for female patients; whether this translates to an increase in healthcare resource use (HRU) and cost is unknown. Therefore, we evaluated the impact of sex on economic burden in symptomatic oHCM.
Medical and pharmacy claims data were assessed from 2016 to 2021 to identify (ICD-10 code) adult patients with symptomatic oHCM in the United States. Generalized linear models were used to estimate HCM-related cost and generalized estimating equations for HRU [both reported as mean per-person-per-year (PPPY)] for healthcare categories: inpatient, outpatient, emergency room (ER), urgent care, and pharmacy. Cox proportional hazard regressions were used to compare differences in male and female patients with symptomatic HCM.
Among 9,490 patients with symptomatic oHCM, 5,309 (55.9%) were female. Female patients were older (64 ± 13 vs. 59 ± 14), with a higher Charlson Comorbidity Index (1.9 vs. 1.7) compared to males, respectively. After adjusting for patient characteristics, female patients had significantly greater number of HCM-related hospitalizations (0.24 vs. 0.20 PPPY, = 0.0014), LOS (5.08 vs. 4.30 PPPY; = 0.0235), number of outpatient visits (4.98 vs. 4.59 PPPY; = 0.0387), and number of distinct drugs (0.59 vs. 0.55 PPPY; = 0.0010), compared with males, respectively. In adjusted models, only HCM-related pharmacy costs were significant, with female patients having slightly higher costs compared to males ($70 vs. $61 PPPY; = 0.0465). There were no significant differences in all-cause costs of care between male and female patients with oHCM. .
Female patients with symptomatic oHCM experience greater rates of HCM-related and all-cause hospitalizations and number of prescriptions, and HCM-related length of stay, outpatient visits, and pharmacy costs compared to male patients.
既往对有症状的梗阻性肥厚型心肌病（oHCM）患者的研究报告称，女性患者的临床负担更重；这是否会转化为医疗资源使用（HRU）和成本的增加尚不清楚。因此，我们评估了性别对有症状oHCM患者经济负担的影响。
评估2016年至2021年的医疗和药房理赔数据，以识别（国际疾病分类第十版编码）美国有症状oHCM的成年患者。使用广义线性模型估计与HCM相关的成本，并使用广义估计方程计算医疗保健类别（住院、门诊、急诊室、紧急护理和药房）的HRU[均报告为每人每年平均（PPPY）]。使用Cox比例风险回归比较有症状HCM男性和女性患者的差异。
在9490例有症状的oHCM患者中，5309例（55.9%）为女性。女性患者年龄更大（64±13岁 vs. 59±14岁），Charlson合并症指数更高（1.9 vs. 1.7）。在调整患者特征后，与男性相比，女性患者与HCM相关的住院次数显著更多（0.24 vs. 0.20 PPPY，P = 0.0014），住院时间（5.08 vs. 4.30 PPPY；P = 0.0235），门诊就诊次数（4.98 vs. 4.59 PPPY；P = 0.0387），以及不同药物数量（0.59 vs. 0.55 PPPY；P = 0.0010）。在调整模型中，只有与HCM相关的药房成本具有显著性，女性患者的成本略高于男性（70美元 vs. 61美元PPPY；P = 0.0465）。有症状oHCM的男性和女性患者的全因护理成本没有显著差异。
与男性患者相比，有症状oHCM的女性患者与HCM相关的住院率、全因住院率、处方数量以及与HCM相关的住院时间、门诊就诊次数和药房成本更高。
